Common reactions to crime

• by
• michael munson

Being the victim of a crime – particularly when the crime involves violence or threats of violence – can be traumatic. The American Psychiatric Association says a person has experienced a trauma if he or she: “experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others [and] the person’s response involved intense fear, helplessness, or horror.”

Traumatic crimes aren’t “over” when the abuse stops and the perpetrator leaves. They aren’t even “over” when any physical injuries heal. Trauma leaves long-lasting, perhaps even permanent, changes in the brain. A study publicized by the American Psychological Association showed that healthy adults who were within 1.5 miles of the World Trade Center’s destruction on September 11, 2001, reacted more strongly to pictures of fearful faces several years after 9/11, compared to other New Yorkers who were living at least 200 miles away on 9/11. The near-neighbors’ brains literally reacted more intensely, as measured by functional magnetic resonance imaging (fMRI), compared to those who were less likely to have felt personally and/or physically threatened by the catastrophe.

Given the fact that even a one-time trauma has the power to alter our brains, it should be no surprise that crime victims can experience a wide range of emotions and reactions. One study found that more than 50% of violent crime victims reported moderate to extreme levels of distress. Common initial reactions include shock, denial, numbness, disorientation, and feeling disconnected from life. Later on, the survivor’s dominant responses may include anger, fear, irritability, hostility, anxiousness, nervousness, depression, grief, frustration, inability to concentrate or make decisions, confusion, guilt (particularly if someone else was victimized at the same time), and sleep and eating disruptions. Survivors’ “peak reaction” (period of strongest reactions or symptoms) may be shortly after the assault, or months or even years later.

Shame and self-blame are common responses, especially for victims of sexual assault and domestic violence. Part of what makes a crime “traumatizing” is that the victim is not in control: the perpetrator is the one determining what’s happening. Paradoxically, humans so strongly need to feel that we can control what happens to us that victims may unconsciously prefer to blame themselves (which means they believe they *could* have controlled the situation if they hadn’t made a mistake or if they had behaved differently) than admit that they had no control over what happened to them. Unfortunately, this “blame the victim” way of thinking is common among those who weren’t victimized, as well. People around the victim oftentimes would also rather believe the victim did something wrong (something that they would never do) than admit that something devastating could happen to them, too.

Trauma survivors often have cognitive and belief struggles, as well. If a person thought the world was a just place where bad people are punished and good people are rewarded, or that a higher power protects those who believe in it, or that he or she was a good judge of people’s characters, becoming the victim of a violent crime can shatter their world. As a result, both existential and mundane worries may consume the survivor: Who can be trusted? Why am I here? Is there a God? Is it safe to leave the house? What if someone doesn’t believe what happened to me? Not surprisingly, many trauma survivors withdraw from loved ones and friends, or find themselves engaging in many more arguments

Most trauma survivors gradually put their worlds and emotions back together again, although they may see and do things differently than they did before the violence occurred. Some, however, develop Post-Traumatic Stress Disorder (PTSD). According to the fifth edition of Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-V), PTSD is defined as:

1. The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows: (1 required)

• Direct exposure.
• Witnessing, in person.
• Indirectly, by learning that a close relative or close friend was exposed to trauma. If the event involved actual or threatened death, it must have been violent or accidental.
• Repeated or extreme indirect exposure to aversive details of the event(s), usually in the course of professional duties (e.g., first responders, collecting body parts; professionals repeatedly exposed to details of child abuse). This does not include indirect non-professional exposure through electronic media, television, movies, or pictures.

2. The traumatic event is persistently re-experienced in the following way(s): (1 required)

• Recurrent, involuntary, and intrusive memories. Note: Children older than 6 may express this symptom in repetitive play.
• Traumatic nightmares. Note: Children may have frightening dreams without content related to the trauma(s).
• Dissociative responses (e.g., flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness. Note: Children may reenact the event in play.
• Intense or prolonged distress after exposure to traumatic reminders.
• Marked physiological reactivity after exposure to trauma-related stimuli.

3. Persistent effortful avoidance of distressing trauma-related stimuli after the event: (1 required)

• Trauma-related thoughts or feelings.
• Trauma-related external reminders (e.g., people, places, conversations, activities, objects, or situations).

4. Negative alterations in cognitions and mood that began or worsened after the traumatic event: (2 required)

• Inability to recall key features of the traumatic event (usually dissociative amnesia; not due to head injury, alcohol or drugs).
• Persistent (and often distorted) negative beliefs and expectations about oneself or the world (e.g., “I am bad,” “the world is completely dangerous.”).
• Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences.
• Persistent negative trauma-related emotions (e.g., fear, horror, anger, guilt or shame).
• Markedly diminished interest in (pre-traumatic) significant activities.
• Feeling alienated from others (e.g., detachment or estrangement).
• Constricted affect: persistent inability to experience positive emotions.

5. Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event: (2 required)

(1) Irritable or aggressive behavior.

(2) Self-destructive or reckless behavior.

(3) Hypervigilance.

(4) Exaggerated startle response.

(5) Problems in concentration.

(6) Sleep disturbance.

1. Persistence of symptoms (in Criteria B, C, D and E) for more than one month.
2. Significant symptom-related distress or functional impairment (e.g., social, occupational).
3. Disturbance is not due to medication, substance use, or other illness.[1]

In simpler terms, trauma survivors are diagnosed with PTSD if they show signs of each of the following for longer than a month:

• Reexperiencing the trauma through flashbacks (memories that feel like they are present reality rather than a memory), nightmares, remembering the trauma when they don’t want to, or reacting strongly to things that remind them of the trauma;
• Avoiding normal parts of life that remind them of the trauma;
• Altering their thoughts and feelings in a negative way, such as negative beliefs about the self or the world;
• Experiencing hyperarousal, or being overly physically and/or psychologically reactive to every day events.

Of course, what we just described are the clinical requirements of a medical diagnosis. In fact, the list of possible consequences of trauma is much, much longer.

Many crime victims benefit from support groups, working with a therapist, and even some prescription medications. Certainly those with PTSD should consider getting help, as many types of therapy, including psychological, body work (e.g., massage or energywork), peer support, and pharmacological have been proven to help reduce the post-trauma symptoms that can make life even harder.

Want to learn more? Here are some resources you can check out:

“Transgender Sexual Violence Survivors: A Self-Help Guide to Healing and Understanding” (includes chapters on all types of trauma as well as on trauma specific to sexual assault) http://forge-forward.org/wp-content/docs/self-help-guide-to-healing-2015-FINAL.pdf

“The Trauma of Victimization” https://victimsofcrime.org/help-for-crime-victims/get-help-bulletins-for-crime-victims/trauma-of-victimization

“Working with Victims of Crime: A Manual Applying Research to Clinical Practice,” available at http://www.justice.gc.ca/eng/rp-pr/cj-jp/victim/res-rech/hill.pdf

More on the research about fearful faces and people living near 9/11 ground zero is available here: http://www.apa.org/news/press/releases/2007/05/brain-function.aspx

“Dealing with the Effects of Trauma: A Self-Help Guide” https://www.unh.edu/counseling-center/dealing-effects-trauma-%E2%80%93-self-help-guide

[1] Retrieved from http://www.ptsd.va.gov/professional/pages/dsm5_criteria_ptsd.asp, April 2, 2015.